[A comparison between changes in EEG and those in some metabolic indices in liver encephalopathy (author's transl)].
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Biomedical subjects
Publications and source records attributed to J Pechar.
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The renal clearance of 21 amino acids was investigated in 5 patients with chronic renal failure (inulin clearance = 5--10ml/min) during the 6-week administration of a low-protein diet. The results were compared with values obtained in 6 volunteers. The renal clearance of all investigated amino acids (with the exception of Asp, His, Tau) did not differ significantly from healthy controls. The excretion fraction (amino acid clearance inulin clearance.100) was in all investigated amino acids significantly higher than in controls with the exception of Tau. The excretion fractions of Asp, Ser, Cys, Tyr, His, Thr, Tau and Gly were, on average, above 20%. The findings suggest that the fractional reabsorption of amino acids in residual nephrons is decreased.
A group of 17 patients with chronic renal impairment and a group of 11 patients surviving for 3--7 years after kidney transplantation were examined. In all patients plasma amino acids were analyzed. The ratio of essential/nonessential amino acids, the valine/glycine ratio and Whitehead's quotient are influenced above all by the dietary protein intake. Raised citrulline and 3-methylhistidine values were not influenced by the protein intake, while they correlate with indicators of renal function. Changes detected after kidney transplantation are analogous.
In patients with chronic renal failure the administration of a diet providing 20 g protein per day for five weeks caused a significant rise in the serum ceruloplasmin level. A low dietary copper content (0.8 mg/day) may have been the limiting factor for any further rise of the ceruloplasmin level. The rise of ceruloplasmin was associated with a continuous decline of total iron binding capacity. The temporarily raised serum iron levels and the continuous decline of unsaturated iron binding capacity suggested enhanced iron mobilization caused by the raised ceruloplasmin level. The rise of ceruloplasmin correlated with the decline of UIBC.
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In eight healthy men a 20-min load of 1.5 W/kg body weight on a bicycle ergometer led to a significant increase of alanine and decline of leucine. Exhausting exercise caused in the same subjects a highly significant increase of alanine and decline of isoleucine, threonine, ornithine, leucine, serine, glycine, and asparasine and glutamine. The methionine and citrulline level declines also significantly. The total amino acids practically did not change. Physical exercise led furthermore to a marked increase of serum ammonia and uric acid. Urea nitrogen changed only little and on average had rather a declining tendency. The rise of alanine suggests the existence of a glucose-alanine cycle, the drop of ornithine and citrulline is most probably associated with the inhibition of ureogenesis in the liver. The reduction of leucine and isoleucine is probably the result of the entry of these amino acids into muscle and their deamination.
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